Are non work-related injuries covered?
Injuries sustained outside of work-related activities are not covered by workers' compensation.
When is an injury not covered?
An injury is not covered if it:
- Occurred while the employee was intoxicated;
- Was caused by the employee's willful intention and attempt to injure himself or another person;
- Was caused by the employee's horseplay;
- Arouse out of an act of a third person intended to injure the employee because of personal reasons;
- Arose out of voluntary participation in an off-duty recreational, social or athletic activity not constituting part of the employee's work-related duties; or
- Arose out of an act of God unless the employment exposes the employee to a greater risk than ordinarily applies to the general public.
What if a claim is filed for an injury that did not occur at work?
Filing a workers' compensation claim and obtaining workers' compensation benefits for non work-related injuries for yourself or for another person is an administrative violation punishable by a penalty up to $5,000. It is a violation to do any of the following:
- Make a false or misleading statement
- Misrepresent or conceal a material fact
- Fabricate, alter, conceal or destroy a document
- Conspire to commit any of the aforementioned
Other repercussions of false workers' compensation claims
In addition to being an administrative violation, intentional commission of any of the aforementioned in an attempt to obtain workers' compensation benefits may result in Class A Misdemeanor to Second Degree Felony charges.
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